Goodman, Mary Lisa

Goodman, Mary Lisa is an individual health care provider with primary practice located at 1807 Short Branch Dr Ste 102 , New Port Richey FL 34655-4424. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Goodman, Mary Lisa can be contacted via phone (727) 376-3547.

Contact Information

Primary practice address
1807 Short Branch Dr Ste 102 New Port Richey FL 34655-4424
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 11014405 Florida

Profile Details

NPI number 1265105803
LBN Legal business name Goodman, Mary Lisa
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2021
Last updated Jul 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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